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General NPI Number Information
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NPI Number | 1659880532
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Entity Type | Individual
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Provider Name | EMILY STONE BRAVO PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/24/2017
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Last Update Date | 03/08/2025
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Provider Practice Location Address
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Address Line | 3028 JAVIER RD STE 300
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City | FAIRFAX
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State | VA
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Zip | 22031-4622
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Country | US
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Telephone | 703-698-8960
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Fax | 772-337-2666
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Provider Business Mailing Address
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Address Line | 3028 JAVIER RD STE 500
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City | FAIRFAX
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State | VA
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Zip | 22031-4622
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Country | US
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Telephone | 703-217-0899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110007773
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License Number State | VA
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